ASWB – 2016 AATOD Conference

2016 AATOD Conference

Saving Lives: Access to Improved Health & Recovery

BALTIMORE MARRIOTT WATERFRONT. BALTIMORE, MARYLAND

 

CONFERENCE OBJECTIVES

 

  • To present the latest evidence relevant to the field and critically evaluate the implications for patients, clinicians, administrators, and policy makers

 

  • To disseminate evaluation and treatment techniques to better serve patients and providers, improve program development and administration, and enhance patient outcomes

 

  • To develop strategies to assist healthcare partnerships and collaborations by advancing their understanding of medication assisted treatment as a crucial element to community wellness in an era of healthcare reform

 

  • To improve the collaboration between opioid treatment programs and community partners in response to the heightened risks associated with the use of opioids

 

  • To formulate methods to promote, support, facilitate, and integrate medication assisted treatment into the judicial and penal systems, government, and social service organizations

 

  • To discuss the magnitude and impact of prescription opioids on the healthcare system and Opioid Treatment Programs

 

 

PRE-CONFERENCE SESSIONS – Saturday, October 29, 2016

 

8:00 a.m.–5:00 p.m.

The Certified Medication Assisted Treatment Advocate (CMA) Training Course

 

Laura McNicholas, MD, University of Pennsylvania, Philadelphia, PA

Joycelyn Woods, MA, MARS Project, Bronx, NY and NAMA-R, New York, NY

Barry Page, Maryland Department of Health & Mental Hygiene, Catonsville, MD

Claude Hopkins, CDAC, JSAS Healthcare, Inc., Neptune, NJ and NAMA-R, New York, NY

Cheryl Blankenship Kupras, LCSW, Santa Clara DADS-AMT Program, San Jose, CA and NAMA-R, New York, NY

Zac Talbott, CMA, Counseling Solutions of Chatsworth, Chatsworth, GA and NAMA Recovery, TN/GA Chapter

Brenda Davis, MSW, Beth Israel Medical Center, New York, NY and NAMA-R,New York, NY

Herman Joseph, PhD, Stop Stigma Now, New York, NY and NAMA-R, New York, NY

Center for Substance Abuse and Treatment, Substance Abuse and Mental Health

Services Administration (SAMHSA), Rockville, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 8

 

The leading advocate and recovery organization for medication assisted treatment, the National Alliance for Medication Assisted Recovery (NAMA Recovery), developed this training believing that professionals, patients and their families can work together for a better understanding of the physiology of addiction and the use of medication assisted treatment (MAT). Both patients and non-patients are encouraged to become Certified Medication Assisted

Treatment Advocates (CMA).

 

The course presentation includes:

Medication Assisted Treatment–Basic clinical information about methadone and buprenorphine treatment.

Addiction & Methadone–Current science about addiction in a language understandable to the non-clinician.

Regulations & Accreditation–Current regulations explained by the federal agency that oversees methadone and buprenorphine treatment, and the State Opioid Treatment Authority.

Basic Advocacy–Basic tools for advocacy, managing simple issues that confront advocates, educating patients about their rights, handling grievances, legal issues, and working within communities to benefit patients and treatment.

 

Participants will gain the initial tools for basic advocacy in order to grow and develop into successful advocates. The course involves eight hours of rigorous training and fulfills the training requirement for Certification as a Medication Assisted Treatment Advocate (CMA).

 

Candidates for certification must register with NAMA Recovery prior to the conference. There is a separate registration fee for the event. The fee includes all materials, 2016/2017 membership in NAMA Recovery, and the application for CMA. Registration information is available at: www.methadone.org. NAMA Recovery cannot guarantee a place to anyone not pre-registered. Lunch is not provided.

 

Sponsored by the National Alliance for Medication Assisted Recovery (NAMA Recovery)

 

Learning Outcome (s): Discuss basic information regarding medication assisted treatment developed by the National Alliance for Medication Assisted Treatment (NAMA Recovery);  Develop an understanding about the science of addiction;  Describe the laws behind methadone and buprenorphine treatment;  Analyze advocacy campaigns to target an issue or respond to negative and incorrect information about medication assisted treatment;  Describe the basic ethics for being an advocate and types of advocacy including handling grievances, systems advocacy, education of policy makers and the community

 

 

8:00 a.m. – 5:00 p.m.

Developing a Peer Program: An Intensive Hands-on Training for OTP

 

Tom Hill, MSW, Senior Advisor, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

Walter Ginter, CMA, Director, Medication-assisted Recovery Services (MARS), New York, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 8

 

One-day training to OTP administrators and staff who are interested in developing a peer recovery support services (PRSS) program. Participants will become familiar with both the concepts of peer practice and the nuts and bolts of program planning and implementation. The training will include both didactic presentations and experiential learning exercises, an emphasis on participatory learning, and opportunities for participants to “workshop” ideas. Mr. Hill and Mr. Ginter will equally co-facilitate the presentations, discussion, and exercises.

 

Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA)

 

Learning Outcome (s):  Identify key factors in implementing a peer mentoring program;  Identify principles that can be applied for people using medication in their recovery;  Describe available resources to improve patient care

 

 

8:00 a.m.–5:30 p.m.

Buprenorphine and Office-Based Treatment of Opioid Use Disorders

 

John A. Renner, Jr., MD, Boston University School of Medicine, Education Section VA Outpatient Clinic, Boston, MA

Laura McNicholas, MD, Philadelphia Veterans Administration Medical Center, Philadelphia, PA

Michael Fingerhood, MD, John Hopkins School of Medicine, Baltimore, MD

 

Course Target Audience: Intermediate & Advanced

 

Number of CE Hours Available: 8.5

 

The “Drug Addiction Treatment Act of 2000” created the opportunity to expand treatment for opioid use disorder into the mainstream of medical practice, increase the number of persons treated, and have an important positive public health impact. The legislation specifies several ways in which physicians can be considered qualified to prescribe and dispense buprenorphine in their offices for the treatment of opioid use disorder. The completion of this training fulfills the requirement prior to notifying the U.S. Department of Health and Human Services (DHHS) of their intention to begin prescribing buprenorphine for the treatment of opioid use disorder.

 

The presentation is designed to train qualified physicians in dispensing or prescribing specifically approved Schedule III, IV, and V narcotic medications for the treatment of opioid addiction in an office-based setting. The goal of this training is to acquire the knowledge and skills needed to provide optimal care to opioid use disorder patients by providing: 1) an overview of opioid use disorder, 2) the efficacy and safety of buprenorphine, 3) process

of patient selection, 4) clinical use of buprenorphine, 5) nonpharmacological interventions, 6) medical psychiatric conditions in opioid use disorder patients, 7) office procedures, and 8) special treatment population. In total this eight hour training will include eight separate modules and four case studies. Each of the speakers will be presenting for two hours. The remaining two hours is broken up over the four case studies.

 

Designated by the DHHS, this training meets the eight-hour requirement and is designed for physicians and other primary care providers to dispense buprenorphine in office practice for treatment of opioid use disorder. Participation in this training will provide physicians with a comprehensive overview of buprenorphine prescribing and its safe and effective use in an office-based setting, such as those in family practice, general internal medicine, psychiatry, pediatrics, adolescent medicine specialists, and Opioid Treatment Programs.

 

Sponsored in part by the Substance Abuse and Mental Health Services

Administration (SAMHSA) and in partnership with the American Academy of

Addiction Psychiatry (AAAP), the American Osteopathic Academy of Addiction

Medicine (AOAAM) and the American Psychiatric Association (APA)

 

Funding for this course was made possible (in part) by 1H79T1022022 from

SAMHSA. The views expressed in written conference materials or publications and

by speakers and moderators do not necessarily reflect the official policies of the

Department of Health and Human Services; nor does mention of trade names,

commercial practices, or organizations imply endorsement by the U.S. Government.

 

Learning Outcome (s): Identify goals of the course and discuss their relevance to opioid dependence;  Discuss buprenorphine efficacy and safety;   Identify legislative changes;  Describe patient selection;  Demonstrate clinical use of buprenorphine;  Discuss non-pharmacological interventions;  Discuss medical and psychiatric conditions in opioid dependent patients;  Discuss special treatment populations;  Demonstrate office procedures

 

8:30 a.m.–12:30 p.m.

Opioid Overdose Prevention and Naloxone Access: Opportunities for Integration into Substance Use Disorder Treatment and Recovery

 

Alice Bell, LCSW, Prevention Point Pittsburgh, Pittsburgh, PA

Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY

Emily Behar, MS, San Francisco Department of Public Health, San Francisco, CA

Melinda Campopiano von Klimo, MD, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

 

Course Target Audience: Intermediate & Advanced

 

Number of CE Hours Available: 4

 

This session will be the first public opportunity to learn about the Substance Abuse and Mental Health Services Administration’s (SAMHSA) detailed overdose prevention and response curriculum, which serves to support implementation of strategies discussed in the Opioid Overdose Prevention toolkit and Federal Guidelines for Opioid Treatment Programs. The session will be delivered by four presenters with varied areas of expertise in overdose prevention, recognition, and response.

 

The presenters will introduce the curriculum, the core concepts, and how to use the curriculum. There will be a discussion of why it is most essential to expand our ability to provide naloxone to those most likely to be present at the scene of an overdose: heroin/opioid users themselves. The presenters will also facilitate discussion of some substance use disorder (SUD) treatment case studies with attendees and various models for integrating overdose prevention in SUD treatment programs and brainstorm some strategies for addressing common barriers.

 

There will also be a discussion of some of the nuanced details of increasing naloxone access through SUD treatment organizations or collaboration with other organizations in the community. With a sample agency policy as a template, attendees will have the opportunity to develop a policy that fits the context of their respective agencies.

 

In addition, there will be a discussion about the opioid safety and integrating naloxone access into primary care clinics, including opportunities to collaborate with the primary care providers of SUD patients. Presenters will provide various patient education materials and lead a discussion with attendees about how to decide which materials are appropriate for different contexts and ways to modify the language so that people perceive that they are the intended audience for the materials.

 

All presenters will facilitate a question and answer session and conclude the session with an explanation of activities and opportunities for overdose prevention support that reflect SAMHSA’s commitment to overdose prevention.

 

Sponsored by the Substance Abuse and Mental Health Services Administration

(SAMHSA)

 

Learning Outcome (s): Describe the current state of the evidence for overdose prevention initiatives and explain the benefits of a multi-faceted plan that includes various collaborators;  Assess existing infrastructure for appropriateness to implement overdose education and naloxone distribution (OEND) initiatives easily and inexpensively and develop strategies for addressing barriers to implementation within those infrastructures;  Design an OEND implementation plan based on local and/or organizational context.

 

 

1:00 p.m.–4:00 p.m.

Medication Assisted Treatment for Pregnant Women with Opioid Use Disorder–Best Practices and Lessons Learned from Kentucky and Massachusetts

 

Sherrye McManus, PhD, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

Kris Shera, SMART Initiative, Frankfort, KY

Laura Sternberger, LICSW, Moms Do Care Project, Boston, MA

 

Course Target Audience: Intermediate & Advanced

 

Number of CE Hours Available: 3

 

This session will present best practices and lessons learned for medication assisted treatment (MAT) for pregnant women who are opioid dependent, as experienced by two current grantees of the Substance Abuse and Mental Health Services Administration (SAMHSA) Medication Assisted Treatment–Prescription Drug and Opioid Addiction (MAT-PDOA) program, Kentucky and Massachusetts.

 

The presentations will provide an overview of the MAT-PDOA program, including current data and research. The presenters will outline the Supporting Mothers to Achieve Recovery through Treatment and Supports (SMARTS) initiative to address the fifteenfold increase over the last decade in NAS cases in Kentucky. They will demonstrate how they are addressing severe service capacity deficits by establishing wraparound care or integrated health care and recovery services using funds from Medicaid expansion and the Affordable Care Act, as well as the SMARTS initiative. The SMARTS initiative also enhances technology infrastructure for performance reporting and MAT education for service providers.

 

The presenters will also describe how they have expanded efforts to identify untreated pregnant women who are opioid dependent and provide them access to evidence-based MAT as part of the Moms Do Care Project in Massachusetts. The project focuses on delivering comprehensive, coordinated, integrated, and trauma-informed prenatal and postnatal primary and behavioral health care. Participants receive individualized MAT and recovery services that support their early and sustained recovery and their choices about continuing medication, and support their efforts to maintain custody of or contact with their children.

 

Sponsored by the Substance Abuse and Mental Health Services Administration

(SAMHSA)

 

Learning Outcome (s): Describe the benefits of integrated care and recovery services for women who are opioid dependent; Identify best practices for providing MAT for pregnant women who are opioid dependent;  Explain workforce training, administrative and program infrastructure, and finances required to introduce and implement these services in communities new to the concept of MAT for pregnant women who are opioid dependent 

 

 

1:00 p.m.–5:00 p.m.

Countering Opioid Stigma: Communicating Messages to Influence Public Perception

 

Lynne Howell Wiklander, BGS, ECG, Inc, Englewood, NJ

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 4

 

Opioid Treatment Programs and patients have historically been the target of negative public opinion and adverse media coverage. This has affected our ability to effectively influence national drug policy, explain the science of opioid addiction and treatment, gain the funding necessary to provide quality treatment to all who require it, and ultimately operate in the best interests of our patients and communities.

 

This session teaches three key messages specifically designed to counter the stigma and stereotypes deeply embedded in the perception of opioid addiction and medication assisted treatment. These messages resulted from a year-long pilot project, “Communicating Messages that Achieve Results.” Participants will hear these messages and learn how to communicate them in order to create a positive impact within their communities. This session will include

Q & A techniques designed to deal with emotional audiences while reinforcing the presentation objectives.

 

For session effectiveness, participation is limited to the first 50 attendees who arrive for the session.

 

Sponsored by the American Association for the Treatment of Opioid Dependence, Inc. (AATOD)

Supported by VistaPharm, Inc.

 

Learning Outcome (s):  Explain how negative public opinion and media affect the field and its ability to influence drug policy; Identify key messages designed to counter the sigma and stereotypes in opioid addiction and MAT;   Describe effective communication techniques with media representatives about the treatment system

 

PRE-CONFERENCE SESSIONS – Sunday, October 30, 2016

 

8:00 a.m.–5:30 p.m.

Opioid Maintenance Pharmacotherapy: A Course for Clinicians

 

Laura McNicholas, MD, Philadelphia Veterans Administration Medical Center, Philadelphia, PA

Abigail Kay, MD, Thomas Jefferson University, Philadelphia, PA

Brian McCarroll, DO, BIO-MED Behavioral Healthcare, Roseville, MI

Kenneth Stoller, MD, Johns Hopkins Bayview Medical Center, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 8.5

 

This course is recommended for clinicians who have an interest in increasing their knowledge of medication assisted treatment (MAT) for opioid use disorder. The updated curriculum includes current consensus guidance for best practice treatment for opioid addiction, focusing primarily on utilization of methadone.

 

Topics include overview of opioid use disorder, epidemiology, opioid pharmacology, evidence-based treatment options, patient assessment/selection, special populations, induction and maintenance protocols, pain management, drug-to-drug interactions, adverse effects, methadone deaths, managing medical/psychiatric problems, drug testing, regulatory issues, an accreditation update, risk management, and an overview of other medication modalities.

 

While the course is primarily intended for clinicians with limited experience in MAT, it also provides updated information for more experienced clinicians. Participants will receive a comprehensive syllabus with reference and resource materials. To further integrate the educational objectives, participants are encouraged to discuss challenging problems and clinical issues to facilitate understanding of didactic principles. Experienced opioid treatment program Medical Directors will conduct the program, focusing on the goal for participants to acquire the essential knowledge and skills necessary to deliver safe and effective medication assisted treatment for patients with opioid use disorder.

 

The $235.00 registration fee includes course materials, morning coffee service, and afternoon luncheon.

 

Sponsored by the American Association for the Treatment of Opioid Dependence, Inc. (AATOD)

Supported by the National Institute on Drug Abuse

 

Learning Outcome (s): Identify interest in the field of Medication Assisted Treatment (MAT) of opioid dependence; Identify best practices in MAT;  Describe and discuss current challenges and relevant case studies to facilitate understanding of didactic principles;  Describe how to deliver safe and effective MAT for patients with opioid dependence

 

 

8:30 a.m.–12:30 p.m.

Countering Opioid Stigma: Communicating Messages to Influence Public Perception

 

Lynne Howell Wiklander, BGS, ECG, Inc, Englewood, NJ

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 4

 

Opioid Treatment Programs and patients have historically been the target of negative public opinion and adverse media coverage. This has affected our ability to effectively influence national drug policy, explain the science of opioid addiction and treatment, gain the funding necessary to provide quality treatment to all who require it, and ultimately operate in the best interests of our patients and communities.

 

This session teaches three key messages specifically designed to counter the stigma and stereotypes deeply embedded in the perception of opioid addiction and medication assisted treatment. These messages resulted from a year-long pilot project, “Communicating Messages that Achieve Results.” Participants will hear these messages and learn how to communicate them in order to create a positive impact within their communities. This session will include

Q & A techniques designed to deal with emotional audiences while reinforcing the presentation objectives.

 

For session effectiveness, participation is limited to the first 50 attendees who arrive for the session.

 

Sponsored by the American Association for the Treatment of Opioid Dependence, Inc. (AATOD)

Supported by VistaPharm, Inc.

 

Learning Outcome (s):  Explain how negative public opinion and media affect the field and its ability to influence drug policy; Identify key messages designed to counter the sigma and stereotypes in opioid addiction and MAT;   Describe effective communication techniques with media representatives about the treatment system

 

 

8:30 a.m.–5:30 p.m.

State Opioid Treatment Authorities’ Meeting (Closed Session for State and Federal Officials)

 

Mitra Ahadpour, MD, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Melinda Campopiano von Klimo, MD, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Anthony Campbell, DO, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Wilmarie Hernandez, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Jinhee Lee, PharmD, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Brandon Johnson, MBA, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Mary Lou Ojeda, MS, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Sidney Hairston, MSN, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Ivette Ruiz, MS-CRP, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Nichole Smith, MSHS, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), Rockville, MD

Drug Enforcement Administration (DEA)

State Opioid Treatment Authorities (SOTAs)

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 8

 

Federal officials, including Substance Abuse Mental Health Services Administration (SAMHSA), the Drug Enforcement Administration (DEA), and State Opioid Treatment Authorities, will convene to share information and discuss a variety of topics of interest to both SAMHSA and the States. Issues of mutual concern in the approval and monitoring of Opioid Treatment Programs, including clinical, administrative, financing, and regulatory policy topics, will be discussed to improve and coordinate joint oversight.

 

Sponsored by the Substance Abuse and Mental Health Services Administration

(SAMHSA)

 

Learning Outcome (s): Identify federal and state regulatory entities overseeing the use of medication assisted treatment (MAT);   Identify best practices in providing oversight of MAT; Describe strategies to improve joint regulatory monitoring of OTPs; Identify strategies to promote joint oversight and compliance with established protocols in medication assisted treatment

 

9:00 a.m.–12:00 p.m.

Delivering Integrated Care in the Era of Health Care Reform: Increasing Access to Care Treatment and Services for Improved Outcomes

 

Megan Marx-Varela, MPA, The Joint Commission, Oakbrook Terrace, IL

Dale Meyer, MS, People Encouraging People, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 3

 

The Behavioral Health Home is an important means by which to unite the diverse components of an individual’s care in order to insure that care, treatment and services provided are accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally effective. With the advent of health care reform, an increasing number of behavioral health care organizations have sought to offer integrated primary physical health care for the individuals and families that they serve.

 

In this workshop we will discuss the decision making process for behavioral health care organizations considering offering integrated care, with a focus on how the provision of medication assisted treatment is included in that process. This will include reviewing a sample of certification standards, and discussing how organizations can achieve compliance with them. For organizations considering obtaining Behavioral Health Home certification this workshop will provide a framework to get started, and for those already certified, it will refine both their understanding of and their approach to offering integrated care.

 

Learning Outcome (s): Define integrated care for the purpose of seeking Joint Commission certification as a Behavioral Health Home; Describe from both a clinical and an administrative perspective, the factors for consideration in the decision making process to determine if they should provide integrated care, how to best provide integrated care in their setting and seek behavioral health home certification; Identify the certification standards utilized to evaluate the behavioral health home, and how they can be implemented in their own organizations

 

 

9:00 a.m.–12:00 p.m.

Extended Release Naltrexone in Parolees, HIV-Infected Patients and Adolescents/Young Adults with a History of Opioid Use Disorder

 

Petra E. Jacobs, MD, National Institute on Drug Abuse, Center for the Clinical Trials Network, (NIDA/CTN), Rockville, MD

Joshua Lee, MD, New York University School of Medicine, New York, NY

Pamela Vergara-Rodriguez, MD, Ruth M. Rothstein CORE Center, Chicago, IL

Shannon Mitchell, PhD, Friends Research Institute, Baltimore, MD

 

Course Target Audience: Intermediate & Advanced

 

Number of CE Hours Available: 3

 

Current medication options to treat opioid use disorders (OUD) approved by the FDA include opioid agonists (methadone, buprenorphine) and antagonist (naltrexone). Since naltrexone does not have reinforcing properties compared to agonists in patients with OUD, lower treatment retention has been noted by clinicians during the last decades and naltrexone has been rarely used. The newly approved long-acting formulation–extended release injectable naltrexone (XR- NTX) promises better compliance than oral naltrexone, given the fact it requires its administration only once a month.

 

The CSAT-NIDA pre-conference session during the 2015 AATOD Conference brought together clinicians, researchers, and administrators to summarize all three medication options and to compare and contrast their utility in patients with OUD. The session presenters received many questions, mostly on XR-NTX as this modality is still unknown to most of the clinicians. Since the 2015 session provided an introduction and an overall great summary of this topic, the presenters will build upon outcomes and conclusions and focus specifically on new knowledge and data related to two clinical trials using XR-NTX in parolees and CJS-involved persons with a history of OUD and in HIV-infected patients with co-occurring alcohol use disorder (AUD) and/or OUD.

 

The presenters will also discuss descriptive findings of staff attitudes and behavior related to prescribing XR-NTX from an ongoing study of XR-NTX treatment in adolescents and young adults with OUD. The session attendees will also have a chance to discuss with presenters their clinical experience in managing patients that are interested in treatment with XR-NTX.

 

Sponsored by the National Institute for Drug Abuse, the National Drug Abuse Treatment Clinical Trials Network (NIDA/CTN)

 

Learning Outcome (s): Identify if a monthly injection of naltrexone is practical and useful in the prevention of relapse of persons leaving jail and community-dwelling outpatient CJS-involved (parolees, probationers) adults, and whether the intervention reduces risk of HIV and hepatitis C infections;  Describe if a monthly injection of naltrexone is acceptable and useful in HIV-infected patients with opioid and alcohol dependence;  Identify how dosing of extended release naltrexone on a monthly-basis can impact both patient overdose risk as well as treatment adherence and retention

 

 

1:00 p.m.–4:00 p.m.

Triple E for HCV: Engagement, Education and Eradication of HCV Among Patients with Substance Use Disorders

 

Stevan Gonsalez, MD, Baylor All Saints Medical Center, Fort Worth, TX

Daniel Fierer, MD, Icahn School of Medicine at Mount Sinai, New York, NY

Lynn Taylor, MD, The Miriam Hospital, Providence, RI

Michael Ninburg, MPH, Hepatitis Education Project, Seattle, WA

Corinna Dan, RN, US Department of Health and Human Services, Washington, DC

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 3

 

Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease (CLD) with an estimated global prevalence of more than 150 million, with up to an estimated 3.2 million infected individuals in the United States. Currently, injection drug use is the leading risk factor for HCV acquisition. In fact, people who inject drugs (PWID) represent the majority of HCV disease burden in developed countries. HCV prevalence among PWID is as high as 80% depending on frequency and duration of use, while incidence ranges from 16-42% per year. Recent FDA-approved HCV treatments can cure >90% of patients without the need for interferon. Despite these facts, HCV treatment uptake amongst PWID participants has been low.

 

Unfortunately, a variety of factors contribute to the limited number of PWID entering HCV care and treatment. Such barriers exist at the patient, physician, and health system levels. Although there are different barriers that are specific to each group, in general these barriers are either 1) based on misperceptions or 2) have become “partially resolved” in the wake of advances in HCV management, healthcare reform including expanded Medicaid coverage for low-income patients, increased pharmaceutical access through public insurance and private indigent care support programs and federal and state government screening mandates. Addressing such barriers is the important first step toward formulating interventions to increase access to care.

 

The Triple E session will be built around a series of expert-led presentations with the integration of real-world cases serving to highlight and reinforce the recognition of, methods for diagnosing, and the management of HCV. These clinical cases will provide abundant opportunities for audience input, faculty presentation, panel discussion, and debate regarding the best treatment strategies for a given patient. This session emphasizes the need to ensure that PWID have access to viral hepatitis prevention, care, and treatment services; to develop and mobilize community resources that prevent viral hepatitis caused by injection drug use; and to advance research into the prevention of viral hepatitis among persons who use drugs.

 

Sponsored by the Chronic Liver Disease Foundation and an educational grant from AbbVie and Gilead

 

Learning Outcome (s): Demonstrate the importance of Hepatitis C screening, diagnosis, and linkage to care; Describe new developments in HCV that have eliminated many of the previous barriers to pursuit of HCV therapy in individuals with a history of substance use; Develop strategies for engagement of patients with a history of substance use into HCV care

 

 

1:00 p.m.–5:00 p.m.

Presentations by the World Federation for the Treatment of Opioid Dependence (WFTOD): EUROPAD Forum

 

The World Federation for the Treatment of Opioid Dependence (WFTOD) was founded during the European Opiate Addiction Treatment Association (EUROPAD) meeting of July 2007 in Ljubljana, Slovenia. All of the member nations, which included the member countries of EUROPAD and all of the member states with AATOD, agreed to a charter for the World Federation.

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 4

 

CHAIRMAN: Icro Maremmani, MD, Santa Chiara University Hospital, Pisa, Italy

INTRODUCTIONS: Michael Rizzi, AATOD International Committee Chair, Cranston, RI

 

1:00 p.m.–1:20 p.m.

Effect of Non-Scheduled Urine Tests among All Students in a Private High School in Las Vegas

Miriam Adelson, MD, Dr. Miriam & Sheldon G. Adelson Clinic For Drug Abuse

Treatment & Research, Inc., Las Vegas, NV, USA

 

1:20 p.m.–1:40 p.m.

Results of the Opioid Substitution Treatment Programs Assessment in Belarus

Alexei Alexandrov, MD, Minsk Regional Clinical Center “Psychiatry-narcology,”

Minsk, Belarus

 

1:40 p.m.–2:00 p.m.

Draft Guiding Principles for Regulations Governing the Use of Agonist Medication in the Treatment of Opioid Dependence

Kevin Journac, MD, Clinique Liberté, Bagneux, France, EU

 

2:00 p.m.–2:20 p.m.

Factors Related to High Methadone Dose Among Patients

Mai Hoai Son, MD, Ho Chi Minh AIDS Center, Ho Chi Minh, Vietnam

 

2:20 p.m.–2:40 p.m.

Educational Intervention for Prevention (from Children to MMT Patients)

Einat Peles, PhD, Adelson Clinic for Drug Abuse Treatment & Research, Tel Aviv, Israel

 

2:40 p.m.–3:00 p.m.

COMPASS Project: Inside and Outside Link for Inmates and Patients Who Inject Drugs with Hepatitis B or C in France

André-Jean Remy, MD, Centre Hospitalier de Perpignan

 

3:00 p.m.–3:20 p.m.

Knowledge about HIV and Risky Behavior Among Methadone Maintenance Treatment Patients

Anat Sason, MMHOS, Adelson Clinic for Drug Abuse, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel

 

3:20 p.m.–3:40 p.m.

Sustainable Methadone Maintenance Treatment Program by Integrated Model–Lesson Learned from Two Clinics

Van Tieu, MD, Ho Chi Minh AIDS Center, Ho Chi Minh, Vietnam

 

3:40 p.m–4:00 p.m.

Promoting the Recovery Oriented System of Care in Low Resource Setting: The Case of Vietnam

Hoang Huy Vu, MPH, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

 

4:00 p.m.–4:20 p.m.

Psychosocial Determinants in the Treatment of Opioid Use Disorder with Buprenorphine

James E. Phelan, LCSW, Veteran Health Administration, Columbus, Ohio, USA

 

4:20 p.m.–5:00 p.m.

Discussion (Questions & Answers)

 

Sponsored by the American Association for the Treatment of Opioid Dependence, Inc. (AATOD), EUROPAD, and the World Federation for the Treatment of Opioid Dependence (WFTOD)

 

Learning Outcome (s):   Describe the work of the World Federation for the Treatment of Opioid Dependence; Explain the field of addiction treatment from different countries (Europe, Asia, US); Interpret prevention, educational/psychosocial approaches and medical treatments according to different cultures and settings

 

 

1:00 p.m.–5:00 p.m.

Partnering to Treat Pregnant Women with Opioid Use Disorders. Lessons Learned from a Six State Initiative

Sharon Amatetti, MPH, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

Nancy K. Young, PhD, National Center on Substance Abuse and Child Welfare, Lake Forest, CA

Martha Kurgans, LCSW, Virginia Office of Substance Abuse Services, Richmond, VA

Christine Scalise, MA, New Jersey Division of Mental Health and Addiction, Trenton, NJ

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 4

 

This session provides guidance to medication assisted treatment (MAT) professionals on how to work collaboratively with partners to engage and treat pregnant women with opioid use disorders. The presentation will provide guidance on collaboration gleaned from the National Center on Substance Abuse and Child Welfare’s (NCSACW) publication, The Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders. The session will further describe tactics used by two states engaged in the NCSACW two-year In-Depth Technical Assistance (IDTA) initiative on Substance Exposed Infants. The initiative, currently serving six states, is strengthening the capacity of states to serve pregnant women with substance use disorders, particularly those with opioid use disorders and their infants with Neonatal Abstinence Syndrome (NAS). Through the initiative, state partners deepened their understanding of barriers that impede or deter women and infants from receiving care. With technical assistance from the NCSACW, state partners created practice, policy, and protocol changes for effective cross-system service delivery for these women and infants.

 

Leaders from New Jersey and Virginia will describe how they worked with state MAT providers through the initiative to build communication and information sharing processes with hospitals, home visitors, and child welfare agencies to create a continuum of care for pregnant women and their children. Both states will discuss their work to increase the use of best cross-system practices such as intensive case management, leading to an increase in the engagement of pregnant and post-partum women in services and an increase in the identification of substance-exposed infants and their engagement in early intervention services.

 

Sponsored by the Substance Abuse and Mental Health Services Administration

(SAMHSA)

 

Learning Outcome (s):  Identify collaborative partnerships necessary to develop a coordinated response to work effectively with pregnant women with substance use disorders and their infants; Describe effective practices for treating pregnant women with substance use disorders in Medication Assisted Treatment (MAT) Programs; Demonstrate examples of information sharing strategies for working with local OB-GYNs and birthing hospitals

 

Poster Author Sessions – Monday, October 31 from 7:30 a.m.–8:45 a.m. and 3:00 p.m.–4:00 p.m.

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: An estimated 10 – 15 minutes is allocated for review of a maximum of 6 posters within 90 minutes (1.5)

 

The following domestic and international posters will provide valuable research findings to treatment providers:

 

Effect of Non-Scheduled Urine Tests among All Students in a Private High School in Las Vegas

Miriam Adelson, MD

 

What is “Treatment” in Drug Courts? A Qualitative Study of Treatment Practices in Indiana Drug Court

Barbara Andraka-Christou, JD

 

Johns Hopkins Cornerstone at Helping Up Mission: A Novel Community-Academic Partnership

Denis Antoine, MD

 

Cannabis, The Anti-Gateway Drug?

Angela Bonaguidi, LCSW

 

Use of Risk Mitigation Practices by Family Nurse Practitioners Prescribing Opioids for the Management of Chronic Non-Malignant Pain

Sahil Chaudhary, BS Candidate

 

Implementation of Overdose Education and Naloxone Distribution (OEND)

Emily Daniell, BSN

Combatting Opioid Overdose

Kelly Dunn, PhD

 

Racial/Ethnic Differences in Primary Drug used among Entrants to Opioid Treatment Programs over Time

Chunki Fong, MS

 

Characterizing Opioid and Benzodiazepine Abuse as Reported by Opioid Treatment Programs in the United States

Jody L Green, PhD

 

Characterizing Opioid and Benzodiazepine Abuse as Reported by Patients Entering Medication-Assisted Substance Abuse Treatment Programs in Europe

Jody L Green, PhD

 

HUB and Spoke Model of Care

Evan Kletter, PhD

 

Usefulness of a Brief Educational Event to Challenge Service Providers’ Approaches with Families

Jan Ligon, PhD

 

A Study of Factors Contributing to Drug Court Graduation

David Masri, PhD

 

Characteristics and Treatment Outcomes among Pregnant Women Maintained on Buprenorphine vs. Methadone

Krystle McConnell, BA

 

Decisions in Recovery: Medications for Opioid Addiction – A Web-Based Shared Decision Making Tool

Niki Ann Miller, MS

 

“No Thanks”: When OTP Patients Refuse a Naloxone Kit for Overdose Prevention

  1. Michelle Peavy, PhD

 

Stress among Methadone Maintenance Treatment Patients, Prevalence and Risk Factors

Einat Peles, PhD

 

Knowledge about HIV and Risky Behavior among Methadone Maintenance Treatment Patients

Anat Sason, MS

 

The Effectiveness and Reproducibility of a Learning Collaborative Strategy to Improve Quality of Care for Rural Buprenorphine Patients with Opioid Use Disorders

Elizabeth Saunders, MS

 

Controlled Substance Monitoring with the Prescription Monitoring Program (PMP) in an Office Based Buprenorphine Program

Julia Shi, MD

 

How Do Peer Recovery Services Groups Work? An Interactional Analysis

Jo L. Sotheran, PhD

 

Increasing Access to Hepatitis C Treatment for Opioid Maintained Patients via Telemedicine

Clewert Sylvester, MD

 

Staff Attitudes and Perceptions Supportive of Overdose Prevention Education in an Opioid Treatment Program

Rosson Wiebe, DNP

 

Optimal Minimum Length of Treatment with Buprenorphine: An Analysis of Resource Use and Costs after Medically Controlled Discontinuation

Vladimir Zah, PhD(c)

 

“Methadone is Making Me Fat!”: Addressing Patients’ Concerns about Methadone and Weight Gain

Cassie Zwart, MSW

 

Learning Outcome (s) Describe current research finding in the field opioid disorder; Identify different methods of care in OTPs; Interpret recent scientific findings in the field of opioid disorder

 

OPENING PLENARY SESSION – Monday, October 31, 2016

 

8:45 a.m.–10:15 a.m.

The Opioid Crisis–Urgent Need for Timely Action

 

MODERATOR:

Vickie L. Walters, LCSW-C, Executive Director, IBR/REACH Health Services,

Baltimore, MD

 

KEYNOTE SPEAKERS:

Honorable Larry Hogan, Governor of Maryland, Annapolis, MD (Invited)

Barbara J. Bazron, PhD, Executive Director, Behavioral Health Administration (BHA), Baltimore, MD

Mark W. Parrino, MPA, President, American Association for the Treatment of Opioid Dependence, Inc. (AATOD), New York, NY

Peter Bruun, Founder, New Day Campaign, Towson, MD

Gilberto Gerra, MD, Chief, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Vienna, Austria

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The Opening Plenary Session will review AATOD’s projects and keynote efforts in Maryland and across the globe. Ms. Vickie Walters, LCSW-C, Conference Chairperson and Program Director, REACH Health Services at Institutes for Behavior Resources Inc. in Baltimore, will welcome conference attendees and provide an overview of this exciting conference. Ms. Walters will be followed by a very special welcome to Maryland by The Honorable Larry Hogan, Governor of Maryland. Governor Hogan will discuss his heroin taskforce, key findings, and recommendations for addressing this epidemic. Dr. Barbara Bazron will discuss Naloxone and Legislative Partnerships in the city of Baltimore. Mr. Mark Parrino, AATOD President, will follow, providing an overview of the challenges, opportunities, and accomplishments of AATOD over the past 18 months and into the future. Peter Bruun, Founder, New Day Campaign, will discuss the engagements of individuals, treatment providers, families, and communities through the arts, to start a discussion and decrease stigma. Gilberto Gerra, Deputy Director, UN Office on Drugs and Crime, will describe international struggles with opioid addiction and the ways it is being addressed.

 

Learning Outcome (s): Identify conference goals; Identify current challenges and solutions for treatment programs; Describe substance abuse treatment in Baltimore, the state of Maryland and internationally

 

WORKSHOP SESSIONS – Monday, October 31, 2016

10:30 a.m.–12:00 p.m.

 

Workshops will offer a chance to review the latest treatment data and health care policies, examine their implications for our patients, and strengthen the skills needed to improve the quality of services.

 

Foundations of Medication Assisted Treatment (MAT) Sessions: We offer a special sequence of workshops designed to act as a refresher for seasoned professionals and to meet the needs of individuals who are new to this field. These sessions are designated as Foundations of MAT.

 

A1 – Methadone 101

Laura F. McNicholas, MD, University of Pennsylvania, Philadelphia, PA

Kenneth B. Stoller, MD, Johns Hopkins University, Baltimore, MD

Yngvild Olsen, MD, Institutes for Behavior Resources, Inc., Baltimore, MD

 

Course Target Audience: Beginning & Intermediate

 

Number of CE Hours Available: 1.5

 

Methadone maintenance treatment within the setting of comprehensive opioid treatment programs (OTPs) has been available for decades. Yet many clinicians and policymakers do not understand how and why it is effective in treating opioid use disorder (OUD). The presenters will review the basic elements of opioid agonist treatment; examine the pharmacologic aspects of methadone; present initial screening, admission, and assessment techniques; describe associated medical, psychiatric, and substance use conditions associated with OUD; describe the efficacy of methadone maintenance; review other OUD pharmacotherapies; and review the continuum of routine and wraparound services that are provided in OTPs.

*Foundations of MAT

 

Learning Outcome (s) Describe the effectiveness of methadone in treating opioid dependence and addiction; Discuss the efficacy and safety of methadone; Identify key bio-psychosocial issues patients may experience during medication assisted treatment.

 

 

A2 – Addressing the Reproductive Health Needs of Women in SUD Treatment

Mishka Terplan, MD, Behavioral Health System Baltimore, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Women with substance use disorder (SUD) have unmet reproductive health needs. Although the Substance Abuse and Mental Health Services Administration promotes integration as central in reducing costs and improving care for individuals with behavioral health conditions, little attention has been placed on the incorporation of family planning in SUD treatment. This workshop will 1) review the unique reproductive health needs of women with SUD and 2) present the findings from a novel pilot study integrating reproductive health screening, education, and service delivery into SUD treatment. Attention will be placed not only on the public health relevance, but also on cost effectiveness of integration strategies and ethical considerations.

 

Learning Outcome (s): Identify the reproductive health needs of women in SUD treatment; Describe how the provision of contraceptive services in treatment supports recovery; Employ strategies for integrating reproductive health for women into treatment

 

A3 – Confronting Opioid Overdose in the OTP: Putting Policies into Practice and Naloxone to Use

Robert Roose, MD, Sisters of Providence Health System, Holyoke, MA

Janet J. Stabile, LICSW, Sisters of Providence Health System, Holyoke, MA

Gwen Fenton, RN, Sisters of Providence Health System, Holyoke, MA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Inpatient and outpatient Opioid Treatment Programs (OTPs) have a critical role in prevention of opioid overdose. Patients in OTPs are at higher risk of overdose upon initiation or discontinuation of treatment and with concomitant substance use. Programmatic and other barriers have prevented many OTPs from realizing their potential in regards to patients, staff, and community education; overdose prevention planning; and naloxone distribution. This workshop uses concrete examples of putting state and program-level policies into action in an OTP to prevent opioid overdose and increase naloxone uptake. Ideas and tools for best practices will be discussed and provided.

 

Learning Outcome (s): Explain the trend of opioid overdose death rates and the role that opioid treatment programs (OTPs) have in prevention of opioid overdose; Describe types of administrative policies and clinical interventions that can be implemented into OTPs; Apply best practices regarding the prevention of opioid overdose into their own OTP with an understanding of both benefits and barriers.

 

A4 – Strengthening the Partnership between OTPs and the Child Welfare System

Anne Gold, MSW, Illinois Department of Children and Family Services, Volo, IL

Rita Houston, MSW, Illinois Department of Children and Family Services, Chicago, IL

Richard Weisskopf, BS, Illinois Department of Human Services, Chicago, IL

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The workshop will provide a description of the development and implementation of training for Illinois child welfare staff to increase their knowledge of current evidence-based practices in opioid dependence treatment; build their competence in supporting patients’ engagement in treatment; and provide them with the skills on safe medication storage for home visits with families. Training outcome data will also be shared including participant testimonials. The presenters will describe the program from initial concept to implementation utilizing a PowerPoint presentation and handouts.

 

Learning Outcome (s)   Describe the development of the partnership between OTPs and Child Welfare System; Develop knowledge about the interaction between Child Welfare personnel and OTP staff; Use the skills to  incorporate safe medication storage training into their home visits with families

 

 

A5 – Integrated Care and the Health Home: Lessons Learned from a Maryland OTP

Angela Fulmer, MSN/MPH, Institutes for Behavior Resources, Inc., Baltimore, MD

Molly Greenberg, RN, Institutes for Behavior Resources, Inc., Baltimore, MD

Yngvild Olsen, MD, Institutes for Behavior Resources, Inc., Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The Health Home is a care model that Opioid Treatment Programs (OTPs) may employ to increase their capacity to provide integrated care and ultimately improve treatment, overall health outcomes, and patient quality of life. There are many barriers to Health Home implementation but with the right knowledge and tools, provider organizations can successfully integrate this model of care. This workshop will introduce attendees to the Health Home concept and describe one operational model for the Health Home, utilizing the implementation of the Health Home in a Maryland OTP as an example. Presenters will share outcomes, best practices, and lessons learned.

 

Learning Outcome (s): Identify key components of the Health Home program and appraise one operational model for the Health Home; Demonstrate perceived benefits of implementing a Health Home; Detect and address barriers in implementing a Health Home

 

HOT TOPIC ROUNDTABLES – Monday, October 31, 2016

1:30 p.m.–3:00 p.m.

 

Hot Topic Roundtables are facilitated discussions that focus on current controversial issues in an informal context. Meet with your colleagues as you learn, challenge, support, and share your views with others who may have similar or different opinions, experiences, or interests. Engage in one or more of these facilitated discussions.

 

Experienced leaders in the field will be facilitating these sessions.

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5 each topic

 

Substance Abuse and Mental Health Services Administration Regulatory Update

Facilitator: Sidney Hairston, MSN

Learning Outcome (s) Describe current regulations from SAMHSA and their importance to patients in treatment; Define resources to improve patient care;  Identify key factors in implementing Medication Assisted Treatment

 

Mergers & Acquisitions: Good for Patients?

Facilitators: Jason Kletter, PhD and Kellie Rollins, PsyD

Learning Outcome (s) Identify trends of mergers and acquisitions in substance abuse treatment; Describe at least three possible impacts OTP mergers and acquisitions can have on patient care.

 

Getting the Political Process to Work for People in Recovery: Platform Review

Facilitator: Legal Action Center

Learning Outcome (s) Describe how politics can impact patient care in an OTP setting; Identify ways in which to have effective change for people in recovery

 

Confronting Stigma and Discrimination in Treatment

Facilitator: Robert Lambert, MA

Learning Outcome (s) Describe how stigma and discrimination in treatment can impact patient care;  Identify barriers to medication assisted treatment

 

What have you done in your community: Building Recovery Partnerships

Facilitators: Zac Talbott, CMA and Ivette Torres, MEd, MS

Learning Outcome (s)   Describe ways in which OTPs can create partnerships within communities to support patients in recovery; Identify ways in which to maintain current partnerships

 

 

WORKSHOP SESSIONS – Monday, October 31, 2016

1:30 p.m.–3:00 p.m.

 

#1 Key Issues on Perinatal Opioid Dependence and Neonatal Abstinence Syndrome

John J. McCarthy, MD, University of California, Davis, Tahoma, CA

Loretta P. Finnegan, MD, The College on Problems of Drug Dependence, Inc.,

Philadelphia, PA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Perinatal opioid dependence presents many challenges for clinicians including the presence of Neonatal Abstinence Syndrome (NAS). The pharmacokinetic science of methadone/buprenorphine dosing in pregnancy and novel use of serum methadone/metabolite ratios as a tool for assessing dynamic metabolic changes in the perinatal period are important for the proper treatment of mother and baby. The concepts of ‘fetal opiate receptor occupancy’ and ‘repetitive intrauterine stress’ will be introduced as factors that affect neonatal health and NAS risks. This presentation will provide clinicians with the knowledge to treat the mother/infant dyad with current strategies to reduce stress upon both of them.

 

Learning Outcome (s) Define the multi-factorial nature of neonatal abstinence syndrome (NAS) symptomatology and the methods of reducing NAS severity by interventions during pregnancy and by proper evaluation and management of the neonate after delivery; Describe the use of mediation assisted treatment in pregnant patients and understand the wide variability in individual metabolism; Identify  the concept of  stable fetal mu opioid receptor occupancy with methadone or buprenorphine can potentially improve neonatal health

 

#2 On-Site Psychiatric Services in an OTP Setting: Why and How?

Linda Hurley, LCDCS, CODAC, Inc., Providence, RI

Laura Levine, CAGS, CODAC, Inc., Providence, RI

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Having mental health counselors and a psychiatrist on staff allows Opioid Treatment Programs (OTPs) to better coordinate care for co-occurring patients. Presenters will describe how CODAC has trained clinicians to screen for mental health disorders during intake, address co-occurring issues, and refer patients into mental health treatment. The presentation also discusses why

CODAC decided to integrate mental health services into patient care and how they developed a comprehensive, sustainable program. The presenters will offer case studies and discuss the philosophy of prescribing. Data supporting CODAC’s approach will demonstrate increased compliance and show rates and, most importantly, positive patient outcomes.

 

Learning Outcome (s) Describe the value of assessing and providing on-site resources for mental illness; Identify how to integrate co-occurring treatment into clinics; Explain one philosophy used for prescribing psychiatric medications

 

#3 Update on Vermont’s Hub and Spoke Model

John R. Brooklyn, MD, University of Vermont College of Medicine, Burlington, VT

Anthony Folland, BA, Vermont State Opiate Treatment Authority, Alcohol and Drug Abuse Programs, Vermont Department of Health, Burlington, VT

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Vermont’s Hub and Spoke model is a comprehensive treatment system for patients receiving medication assisted treatment (MAT) for opioid dependence in existence since 2013. The challenges and successes of this system will be discussed. Data showing increased access to MAT statewide, reduction in waiting lists, expansion of OBOT practices, and increases in people treated per waivered MD will be shown. Details about the MAT embedded team development under Vermont’s Chronic Care Initiative as part of the Blueprint for Health will be discussed.

 

Learning Outcome (s): Describe the concept of the Hub and Spoke Model; Explain the current systems of care; Identify similar models of care that can be implemented in at other locations

 

WORKSHOP SESSIONS – Monday, October 31, 2016

4:00 p.m.–5:30 p.m.

 

B1 – Ending Stigma’s Harm: Patients and Providers United for Health and Recovery

Herman Joseph, PhD, Stop Stigma Now, New York, NY

Joycelyn Woods, MA, NAMA Recovery, New York, NY

Zac Talbott, CMA, Counseling Solutions of Chatsworth, Chatsworth, GA and NAMA Recovery, TN/GA Chapter

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

From the start of methadone treatment, patients have faced an increasing and pervasive social stigma comprised of misleading media, major social institutions, family, and friends. Prejudice and stigma have become the primary social forces confronting patients in Medication Assisted Treatment (MAT). For quality MAT to fulfill its potential, it will be necessary to challenge and end this negative influence. The various prejudices that patients face in their road to recovery include: language, family, criminal justice system, child welfare, health care, education, employment, life insurance, etc. The workshop concludes with strategies to end the stigma that patients experience.

*Foundations of MAT

 

Learning Outcome (s): Describe the history of stigma and prejudice to patients and treatment and the rationale behind it; Detect the impact that stigma has on patients and have solutions to assist patients with stigma and prejudice; Identify the current nationwide strategies to end stigma and instructions on how to participate in order to stop the stigma and prejudice.

 

B2 – Integrating Mindfulness Based Parenting into an Opioid Treatment Program

Diane Abatemarco, PhD, Thomas Jefferson University, Philadelphia, PA

Meghan Gannon, PhD, Thomas Jefferson University, Philadelphia, PA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The “Practicing Safety Mindfulness Project for Mothers in Drug Treatment” is a federally funded multi-faceted intervention aimed at reducing the toxic stress children of families with substance use disorders endure. One dimension of this intervention is the implementation of a 12-week mindfulness based parenting intervention for mothers of children aged 3 to 36 months. This workshop describes the integration of mindfulness into an opioid treatment program. Participants will also experience mindfulness-based stress reduction practices. Lastly, findings and results will be provided that demonstrate the effect of the intervention on individual psychosocial, parenting, and maternal domains.

 

Learning Outcome (s): Describe mindfulness exercises and strategies that increase self-compassion of oneself and their child in this population: Demonstrate how the intervention improved the quality of parenting behaviors of women in medication assisted treatment for opioid dependence; Identify key assets to sustainability of integrating a mindfulness program at a treatment center.

 

B3 – What to Do When Courts, Insurers and Others Block Effective Treatment

Sally Friedman, JD, Legal Action Center, New York, NY

Karla Lopez, JD, Legal Action Center, New York, NY

Melissa Trent, JD, Legal Action Center, New York, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Individuals often cannot access medication assisted treatment (MAT) because criminal justice and child welfare agencies will not allow it and insurers will not cover it. This workshop explains how to overcome these barriers. The presenters will explain legal mandates and advocacy strategies featured in Legal Action Center’s two groundbreaking reports, “Medication-Assisted Treatment in Drug Courts: Recommended Strategies” and “Health Insurance for Addiction & Mental Health Care: A Guide to the Federal Parity Law.” Participants will learn how to work with courts and others to permit MAT and how to identify and challenge parity violations.

 

Learning Outcome (s): Demonstrate ways to advocate for patients’ access to medication assisted treatment (MAT) in the criminal justice and child welfare systems; Identify at least five components of successful collaborations between drug treatment courts and treatment programs, contributing to successful use of MAT in the criminal justice system: Describe the requirements of the federal parity law, including requirements that health insurers cover medication assisted treatment for addiction

 

B4 – Integrating HCV Care into a Opioid Treatment Program

Lynn E. Taylor, MD, Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, RI

Sophie Sprecht-Walsh, LPN, CODAC, Inc./University Medicine, Cranston, RI

Linda Hurley, LCDCS, CODAC, Inc., Providence, RI

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

People who inject drugs have the highest incidence/prevalence of HCV, yet a minority of HCV-infected persons with opioid addiction undergoes HCV treatment. Presenters will discuss implementation of an on-site HCV clinic at CODAC, an Opioid Treatment Program (OTP) in Providence, RI, and how on-site HCV care in OTPs overcomes barriers to treatment. HCV clinic outcome data will be presented, including cure rates and consequences of late diagnosis. We will also discuss the potential benefits for staff utilization and improved patient outcomes. Participants will learn how to replicate all or part of the initiative at their own programs.

 

Learning Outcome (s): Explain the rationale for evaluating, treating and curing hepatitis C in an Opioid Treatment Program; Compare key findings from studies evaluating HCV treatment efficacy, benefit and safety among people who use drugs; Demonstrate how to implement on-site integrated hepatitis C care

 

 

B5 – How to Prevent Employment Discrimination and Harassment Claims

Kathryn J. Russo, Esq., Jackson Lewis P.C., Melville, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop will provide practical advice to employers on preventing discrimination, harassment, and retaliation in the workplace–in several different contexts. The presenter will discuss best practices with respect to lawful hiring, why written performance evaluations are critically important and how to write them so that they protect your organization from legal claims by employees, and how to handle internal complaints of discrimination and retaliation made by employees. Additionally, the speaker will address how to discipline employees; evaluate the appropriate severity of discipline, up to and including termination; and how to document disciplinary actions properly to avoid potential lawsuits from employees.

 

Learning Outcome (s): Describe best practices with respect to lawful hiring; Demonstrate how to handle internal complaints of discrimination and retaliation made by employees,  Explain how to discipline employees appropriately, to avoid potential discrimination and retaliation claims

 

 

 

The New Day Campaign: Where Stigma Ends, Healing Begins

6:30 p.m.–8:30 p.m.

 

Peter Bruun, New Day Campaign, Towson, MD

Robert Schwartz, MD, Friends Research Institute, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 2

 

The strategy of the session, The New Day Campaign: Where Stigma Ends, Healing Begins, is to bring participants together with art, heart, and humanizing. Once participants are in a place of caring and healing, discussion of the many aspects of dealing with stigma and paths to action will lead to participants leaving with the motivation and information to work in their communities, programs, and personal lives on ending stigma for those with substance use disorders. The presentation is interactive and includes time for reflection, discussion, and engagement with the presenters and the audience. The presentation includes a presentation of evidence-based treatment models, meditation, poetry, filmography, audiography, song, visual arts and conversation meant to inspire, engage, and question, and a discussion of the dance between art, healing, and anti-stigma.

 

Sponsored by Friends Medical Laboratory, Inc. and Institutes for Behavior Resources, Inc.–REACH Health Services

 

Learning Outcome (s):  Identify gaps in needed non-traditional treatment and recovery services for the patient population; Demonstrate how incorporating meditation, arts and other alternative forms of treatment can reduce stigma and improve patient care; Apply learned techniques to address challenges faced by treatment programs

 

 

MIDDLE PLENARY SESSION – Tuesday, November 1, 2016

 

8:45 a.m.–10:15 a.m.

Saving Lives: Access to Improved Health & Recovery

 

MODERATOR:

Kimberly A. Johnson, PhD, Director, Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

 

KEYNOTE SPEAKERS:

Leanna Wen, MD, Commissioner, Baltimore City Health Department, Baltimore City Opioid Taskforce, Baltimore, MD

Elijah Cummings, JD, United States Congressman, Maryland’s 7th District, Baltimore, MD (Invited)

Vice Admiral Vivek Murthy, MD, Surgeon General, United States Department of Health & Human Services, Washington, DC (Invited)

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The Conference Theme, Saving Lives: Access to Improved Health and Recovery requires renewed focus on supported recovery, data-driven decision making, and planned outcomes. This themed plenary session features three leaders and champions of the recovery movement. Moderated by Dr. Kimberly A. Johnson, this plenary will focus on engaging communities and promoting recovery. Dr. Leanna Wen, Baltimore City Health Commissioner, will provide an overview of Baltimore’s Opioid Taskforce and recommendations. The taskforce was convened to address the critical problem of opioid addiction in Baltimore. Its goal is to study the problem of heroin addiction and propose solutions for improving access to effective treatment and neighborhood compatibility. Congressman Elijah Cummins will share the scope of the drug abuse problems in Maryland, its effect on our community, and our response. Growing up in

Baltimore, Congressman Cummins has witnessed the destructive nature of opioid and heroin addiction, which destroys lives and tears a part families and communities. The plenary will conclude with a keynote address from General Vivek Murthy, US Surgeon General. The U.S. Surgeon General is preparing a first-of-its-kind report, presenting the state of the science on substance use, addiction, and health. The report will highlight the best scientific evidence on treatment and recovery, and seek to erase the stigma surrounding addiction. During this plenary you will hear from different perspectives, each will show how engagement and recovery changes patients’ lives, strengthen families and supports communities.

 

Learning Outcome (s):  Identify what recovery means to a patient and community; Describe the impact of Baltimore’s Opioid Taskforce;  Describe the impact of drug abuse problems and the response from the communities;  Describe the state of the science on substance use, addiction and health

 

WORKSHOP SESSIONS – Tuesday, November 1, 2016

10:30 a.m.–12:00 p.m.

 

C1 – Building Therapeutic Partnerships: The Most Important Evidence-Based Practice

Robert C. Lambert, MA, Connecticut Counseling Centers, Inc., Danbury, CT

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Research indicates that the quality of the therapeutic relationship has a greater effect on patient retention and outcomes then the specific counseling approach used. This workshop will focus on the opportunities and unique challenges involved in enhancing the therapeutic alliance with medication assisted patients within the MAT clinic setting, a review of the fundamentals of forming and maintaining a therapeutic relationship, and the factors that affect the quality of the therapeutic relationship. We will also explore patient expectancy as a therapeutic factor, and discuss the use of patient feedback to strengthen the therapeutic alliance.

*Foundations of MAT

 

Learning Outcome (s): Discuss the common therapeutic factors that affect treatment outcome and review specific factors that affect the quality of the therapeutic relationship; List an overview of core counseling skills used to form and maintain a therapeutic relationship; Identify factors specific to Opioid Agonist Treatment that may interfere with the counselor’s attempts to form and maintain the therapeutic relationship

 

C2 – Treating Pregnant/Parenting Opioid-Dependent Women and Their Children

Shahid Ali, MD, Elam Mental Health Center, Nashville, TN

Mishka Terplan, MD, Behavioral Health System Baltimore, Baltimore, MD

Lauran Jansson, MD, Johns Hopkins University School of Medicine, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop will present recommendations for the treatment of pregnant and parenting opioid-dependent women and their children derived from the RAND/UCLA Appropriateness Method, which assesses the appropriateness of clinical procedures with limited scientific evidence. Using current scientific evidence and clinical judgment, nine expert panel members rated the appropriateness of 285 clinical scenarios; each scenario describes a patient and a potential procedure for treatment (indications). Three expert panel members will discuss

indications that were rated with agreement and topics for which there was disagreement among expert panel members and for which gaps remain. Input from audience members will be sought.

 

Learning Outcome (s): Identify recommended treatment practices for opioid-dependent pregnant and parenting women and their children; Describe scenarios or practices of clinical uncertainty; Explain treatment approaches used in participants’ programs

 

C3 – Maricopa County Correctional Health  Methadone Program

Jeffrey Alvarez, MD, Maricopa County Correctional Health Services, Phoenix, AZ

Rick Christensen, PA, Community Medical Services, Phoenix, AZ

Michael C. White, MCJ, Community Medical Services, Phoenix, AZ

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Dr. Alvarez, the Director of Maricopa County Corrections, will address the process of developing a jail Opioid Treatment Program, collaborating with a community provider, and expanding medication assisted treatment to include all jail populations/demographics, along with Maricopa County Drug Courts and local Diversion Programs. Rick Christensen of Community Medical Services will discuss the development and implementation steps required to create the proper continuum of care and changes in culture needed to sustain the program. Michael White will discuss the Collective Impact Model along with Community Based Services to better support patients navigating multiple systems, accessing needed resources, and establishing a foundation of community partners.

 

Learning Outcome (s): Identify the many regulatory and accreditation barriers to developing a jail OTP,  Describe the complicated issues in implementing these services in jail settings; Explain the development of system teams collaborating with various departments with the state, county and community partner programs 

 

C4 – Pharmacotherapy Update: Cardiac Safety Considerations Beyond Methadone and the Role of Psychiatry in Implementation of a Cardiac Safety Program

Mori J. Krantz, MD, Denver Health, Denver, CO

Mark C.P. Haigney, MD, Uniformed Services University, Bethesda, MD

Megan A. Marx-Varela, MPA, Joint Commission, Oakbrook Terrace, IL

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Cardiac and central nervous system (CNS) safety of opioid agonist therapy is increasingly scrutinized given rising opioid-related fatalities. Knowledge gaps exist regarding the risk of cardiac toxicity of drugs beyond methadone and buprenorphine. A number of over the counter preparations appear to have a QTc-prolongation liability. Numerous drug-drug interactions may increase this liability. These will be presented in categories for practical implementation. We

will also discuss the implementation of a collaborative training of psychiatrists that include ECG interpretation with oversight by cardiologists. This training proved to be preliminarily successful. These activities are supported by ongoing quality and accreditation processes in Opioid Treatment Programs.

 

Learning Outcome (s): Define prescription, over the counter and dietary supplement products that may increase cardiac and CNS risk among opioid agonist patients; Describe pitfalls and successes of a pilot program of psychiatrist over-reading of ECGs as part of a cardiac safety program; Identify strategies including joint commission accreditation standards that can improve implementation of clinical safety activities

 

C5 – Challenges to Opioid Treatment Providers after Hurricane Sandy

Harlan Matusow, PhD, National Development and Research Institutes, New York, NY

Ellen Benoit, PhD, National Development and Research Institutes, New York, NY

Andrew Rosenblum, PhD, National Development and Research Institutes,

New York, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

During and after Hurricane Sandy, methadone maintenance patients faced obstacles to obtaining treatment. This session describes ways in which Opioid Treatment Program (OTP) staff anticipated and responded to service disruptions (based on evaluations of emergency plans and interviews with staff, administrators, and State officials; State Opioid Treatment Authorities (SOTAs)) and, patient and drug user experiences during and after the Storm (based on focus groups with patients and out-of-treatment drug users).Recommendations, evaluated for usability and feasibility by a nationwide sample of OTP directors and SOTAs, for improving continuity of care in future emergencies are presented. Key areas of focus include Communication, Transportation, and Technology.

 

Learning Outcome (s): Describe what types of Continuity of Operations Plans (COOPs) were in place at OTPs prior to Hurricane Sandy and did the plans adhered to SAMHSA disaster planning guidelines; Explain how Hurricane Sandy affected OTPs operations, staff, administrators, and patients; Identify policy recommendations generated from research findings and the usability and feasibility

 

WORKSHOP SESSIONS – Tuesday, November 1, 2016

1:30 p.m.–3:00 p.m.

 

D1 – Meeting the Needs of Patients with Co-Occurring Disorders: Skills for Counselors

Joan E. Zweben, PhD, University of California, San Francisco & EBCRP, Berkeley, CA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop is intended to acquaint new counselors with key elements of treatment for people with co-occurring disorders and provide an update for existing counselors, including a brief review of research evidence supporting certain approaches. The workshop will begin with brief comments on the epidemiology of co-occurring disorders, barriers to addressing them, and how untreated psychiatric conditions affect recovery and quality of life. The basic principles for distinguishing between substance-induced symptoms and independent disorders, as well as a focus on disorders common in opioid dependent patients, such as anxiety disorders (especially PTSD), and mood disorders (especially depression), will be discussed. We will also review screening and assessment of suicide risk from the perspective of agency protocols as well as the role of the counselor.

*Foundations of MAT

 

Learning Outcome (s): Identify and describe three common psychiatric disorders in opioid treatment; Describe three appropriate treatment principles for patients with psychiatric conditions; Describe three key elements in forming good collaborations with physicians and other professionals.

 

D2 – Mobile Health Apps to Address Opioid Use Disorders

Doris Titus-Glover, PhD, Optimal Solutions Group, LLC, College Park, MD

Kate Durocher, BA, Abt Associates, Bethesda, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The literature notes that mobile phones and mHealth applications present a significant opportunity to provide patients with substance use disorders with evidence-based treatment. Researchers and government agencies have begun to explore the use of mHealth to address a number of chronic conditions, including substance use disorders and HIV. Specifically, the Substance Abuse Mental Health Services Administration (SAMHSA) has hosted several challenge grants to develop innovative solutions to address opioid use disorders. In addition, SAMHSA is exploring the feasibility of utilizing mHealth as a recovery support for patients in MAT programs. In this session, presenters discuss the opportunity technology based solutions provide to addressing opioid use disorders.

 

Learning Outcome (s): Define and describe the use of mobile health applications (mHealth); Explain the potential for these applications to provide clinical and recovery support for opioid use disorder and opioid overdose; Describe federal efforts to assess and develop mHealth technology for opioid use disorder and opioid overdose.

 

D3 – The Five-Year Recovery Standard for Medication Assisted Treatment

Robert L. DuPont, MD, Institute for Behavior and Health, Inc., Rockville, MD

Wilson M. Compton, MD, National Institute on Drug Abuse, Rockville, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Sustained five-year recovery as a primary measure of substance use disorder (SUD) outcomes can reshape both treatment outcome research and clinical practice. In this context, the definition of recovery is that of the Betty Ford Institute Consensus Panel, including no use of alcohol, marijuana or other drugs of abuse. The use of medications as prescribed in medication assisted treatment (MAT) is fully compatible with recovery. Physician health programs serve as a model of chronic disease management for SUDs, including opioid use disorders. Use of the five-year recovery standard will encourage all treatment programs to focus their attention on long-term patient outcomes.

 

Learning Outcome (s): Describe  the mismatch between the duration of MAT for almost all patients and the lifelong nature of addiction; Identify the outcomes of care management for opiate dependent patients, including those using opiates intravenously; Describe the proposed five-year recovery standard and relate it specifically to MAT.

 

D4 – Public Health Solutions for Opioid Addiction and Overdose

Leana Wen, MD, Baltimore City Health Department, Baltimore, MD

Adrienne Breidenstine, MSW, Behavioral Health System Baltimore, Baltimore, MD

Natanya Robinowitz, MSPH, Behavioral Health System Baltimore, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Baltimore declared opioid overdose a public health emergency and is leading one of the most aggressive opioid overdose prevention campaigns across the country. With 19,000 active heroin users, and far more who misuse opioids, Baltimore cannot be healthy without addressing this problem. This workshop will focus on Baltimore’s opioid addiction and overdose response plan and the opportunities and challenges involved in implementing a community-focused plan to address this epidemic.

 

Learning Outcome (s) Identify three key components that should be part of a comprehensive community plan to address opioid addiction and overdose; Define the role of a local public health and/or behavioral health authority in implementing a community opioid addiction and overdose response plan and examine ways to collaborate with state and local partners; Describe policy changes/reforms that need to occur at the federal level to address opioid addiction and overdose

 

D5 – Retaining Patients While They Contemplate Change: A Model to Curb Discharge

  1. Michelle Peavy, PhD, Evergreen Treatment Services, Seattle, WA

Paul Grekin, MD, Evergreen Treatment Services, Seattle, WA

Molly Carney, PhD, Evergreen Treatment Services, Seattle, WA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

 

Number of CE Hours Available: 1.5

 

Opioid Treatment Programs (OTPs) face a dilemma when it comes to discharging or not discharging unstable drug using patients. Premature death looms as a possible outcome for discharged patients; however, dangling the threat of discharge can serve as a powerful motivator for change. Furthermore, active drug users may be perceived as hazardous to a safe and therapeutic environment. In this workshop we will: describe an OTP policy that enhances retention by discontinuing discharge due to ongoing drug use; examine how this policy change affected the milieu; and discuss clinical implication of this policy in the context of the current heroin epidemic.

 

Learning Outcome (s): Describe a model/policy designed to enhance retention among individuals who struggle with ongoing drug use; Explain how this policy may affect relevant treatment variables including clinic attendance, incident reports, and patient satisfaction; Discuss clinical implications of policies that promote retention, and encourage such policy changes in the context of the current heroin epidemic

 

International Presentations: Risks of an Inadequate Methadone Maintenance Protocol

3:15 p.m.–4:45 p.m.

 

SPEAKERS

Icro Maremmani, MD, Santa Chiara University Hospital, University of Pisa, Pisa, Italy

Angelo Giovanni Icro Maremmani, MD, School of Psychiatry, University of Pisa, Italy

Matteo Pacini, MD, G. De Lisio Institute of Behavioural Sciences, Pisa, Italy

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Alcohol Abuse in Heroin Use Disorder Patients: An Unfolding Metabolic Destiny

 

The presenters, on the basis of their clinical experience, suggest that poly drug abuse in heroin addicts could be correlated with condition of opiate dependence improperly compensated by street heroin or by agonist opioid treatment dosages. Thus the search for an appropriate methadone dosage is crucial not only because it enhances patients’ retention rate within the treatment group, allowing an improvement in social rehabilitation, but also because it reduces the risk of poly drug abuse.

 

Former Heroin Use Disorder Patients Now Alcohol Use Disorder Patients (FHA-AUD): Addiction History and Clinical Feature

 

The prevalence of FHA-AUD patients is not negligible. This may relate to previous inadequate treatment of heroin addiction contributing to the development of severe AUD. For these patients we propose a reconsideration of ‘soft’ (low dose) agonist opiate treatment.

 

Treatment of Alcohol Misuse during Methadone Treatment and Treatment of Alcohol Misuse in Former Heroin Use Disorder Patients

 

After reviewing the data in the literature on the use of Gamma Hydrossibutiric Acid (GHB) in alcoholics and other kinds of abusers, several cases of alcohol abusing heroin addicts will be described, in which adequate dosages of methadone and the use of GHB proved to possess some effectiveness, even if there were major limitations regarding compliance and completeness of response. In responding to the challenge of identifying different alcoholic sub-groups that can benefit from specific treatment, we want to shed light on the idea that alcoholics with a history of heroin use should be considered a specific group, and a treatment target should be set on the rebalancing of the opioidergic system after passing through agonist opioid treatment.

 

Learning Outcome (s): Identify the risk of shifting from heroin abuse to alcohol abuse; Describe the need of an adequate methadone dosage to avoid the development of a severe alcohol use disorder; Define a combined treatment of alcoholic/heroin addict patients

 

WORKSHOP SESSIONS – Wednesday, November 2, 2016

8:00 a.m.–9:30 a.m.

 

E1 – Mobile Technology To Improve Treatment For Substance Use Disorders

Eileen Zeller, MPH, Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD

Amy Shanahan, MS, University of Pittsburgh Medical Center, Pittsburgh, PA

Dolores Justice, MA, University of Pittsburgh Medical Center, Pittsburgh, PA

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop will explore working with patients experiencing co-occurring substance use disorder (SUD) and suicidal behavior. The presenters will describe the connection between substance use and vulnerability to suicide and will also provide guidance on conducting a suicide assessment and triage and demonstrate the use of the Suicide Safe mobile app. Various app features will be explored as tools to improve clinical practice, and the workshop will highlight a case study from the app focused on suicidal behavior in a person with SUD. The presenters will also describe a new mobile app that supports medication assisted treatment, especially among opioid users.

*Foundations of MAT

 

Learning Outcome (s): Identify at least two factors that may create vulnerability to suicidal behaviors among persons with substance use disorders; Describe the SAFE-T approach to suicide assessment and triage; Identify at least two ways SAMHSA’s apps may help providers in their care of patients.

 

E2 – Using Medications to Treat Opioid Dependence among Prisoners

Michael S. Gordon, DPA, Friends Research Institute, Baltimore, MD

Terrence T. Fitzgerald, MD, Glenwood Life Counseling Center, Baltimore, MD

Robert P. Schwartz, MD, Friends Research Institute, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

In the US, there are over 1.5 million state and federal prisoners, of whom an estimated 15% have histories of opioid dependence. Despite the availability of effective FDA-approved medications most opioid-dependent inmates remain untreated. As a consequence, opioid use resumes rapidly placing newly released inmates at high risk for opioid overdose death or return to criminal activity and re-incarceration. This workshop will present recently completed trials of buprenorphine and extended release naltrexone for pre-release prisoners in Baltimore and provide practical implications of research findings, the unique challenges of providing these medications to prisoners, and to linking patients to community programs after release.

 

Learning Outcome (s): Identify potential benefits to treat opioid dependence in prison; Describe challenges to using long-acting naltrexone and buprenorphine in prison; Explain ways to overcome linkage to community programs for released prisoners on medications

 

E3 – Federal Addiction Policy: Building on our Accomplishments and Looking Ahead

Gabrielle de la Gueronniere, JD, Legal Action Center, Washington, DC

Paul Samuels, JD, Legal Action Center, New York, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

The addiction care system continues to face tremendous change and upheaval. While we have a certain degree of clarity about the legal and regulatory framework of the Affordable Care Act and the parity law, much work remains to fully implement both laws and to ensure that their consumer protections are adequately enforced. As we approach a new presidency and a new Congress, this workshop will review recent developments at the federal level aimed at improving access to addiction care, including medication assisted treatment. Workshop presenters will also discuss potential future federal developments related to substance use disorder treatment, the future of medication assisted treatment in the new health reform environment, delivery system reforms, and opportunities available for improving federal policy moving forward.

 

Learning Outcome (s): Name health policy changes happening on the federal level, particularly related to coverage for and access to medication assisted treatment: Describe recent and ongoing changes in federal health care policy will impact the delivery and financing of substance use disorder care; Explain how to respond to health care reform implementation efforts happening in various states and communities. 

 

E4 – Benzodiazepines and Opioids: An Update

Yngvild Olsen, MD, Institutes for Behavior Resources, Inc, Baltimore, MD

Christopher Welsh, MD, University of Maryland School of Medicine, Baltimore, MD

Anika Alvanzo, MD, Johns Hopkins University School of Medicine, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

There is growing epidemiologic data on overdose fatalities associated with opioids and benzodiazepines. Clinicians caring for patients taking methadone or buprenorphine often struggle with what to do when patients also use illicit or prescribed benzodiazepines. Using a case based format, this workshop will review contextual data and survey results for how opioid treatment programs deal with concurrent benzodiazepine use. Presenters will focus on recent clinical guidelines, practical ways to reduce safety risks, including the use of technological tools, and discuss broader policy initiatives such as the Food and Drug Administration petition for black box warnings on all prescription opioids and benzodiazepines.

 

Learning Outcome (s): Identify concurrent benzodiazepine use in OTPs patients; Demonstrate ways to reduce risk for patients using benzodiazepine in OTPs; Define clinical guidelines in OTPs

E5 – Opportunities for Using Addiction Medications: NYS Recipe for Success

Robert A. Kent, Esq., New York State Office of Alcoholism and Substance Abuse Services (OASAS), Albany, NY

Charles W. Morgan, MD, New York State Office of Alcoholism and Substance Abuse Services (OASAS), Rochester, NY

Belinda M. Greenfield, PhD, New York State Office of Alcoholism and Substance Abuse Services (OASAS), New York, NY

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Although New York State (NYS) has a robust Opioid Treatment Program (OTP) system that has a solid historical foundation and serves the largest number of patients nationally (over 38,124 patients daily), the state continues to struggle with addiction medication adoption and access. NYS leadership have developed strategies to improve addiction medication access and concomitantly increase the substance use disorder (SUD) field capacity to integrate pharmacological agents alongside counseling services. This workshop will delineate these strategies, presenting both challenges and solutions to improve SUD treatment quality. The workshop’s goal is to help states with their own medication assisted treatment adoption, access and capacity gaps by considering NYS’ action plan.

 

Learning Outcome (s): Define mechanisms on how to  work with managed care organizations / insurers in leveraging a MAT agenda; Describe  solutions to challenges that New York State is facing in expanding medication assisted treatment access and capacity statewide, particularly in providing access to MAT in rural, non-substance use disorder settings, adolescent consumers and within criminal justice settings; Identify ways to expand the state’s OTP system’s capabilities in treating opioid and other addictive disorders and building an integrated comprehensive service.

 

WORKSHOP SESSIONS – Wednesday, November 2, 2016

9:45 a.m.–11:15 a.m.

 

F1 – Changing People Places and Things: A Community Support Intervention

Michael Kidorf, PhD, Johns Hopkins University School of Medicine, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

How do we help patients change “people, places, and things”? This workshop describes a Community Support Intervention (CSI) group that creates partnerships with patients and drug-free family and friends to expand abstinence support and modify social networks. This workshop has three components. The first describes the rationale for formally including family and friends in treatment. The second describes the CSI approach, in which patients and their supports participate together in recovery-oriented community activities, and discuss their experiences in the group setting. The final component presents data on CSI and strategies to adapt it to other outcomes (e.g., retention, service utilization).

*Foundations of MAT

 

Learning Outcome (s): Define new therapeutic factors that affect treatment outcome; Identify barriers to developing therapeutic relationship with family and friends; Describe implementation of Community Support Intervention

 

F2 – Understanding/Embedding Tobacco Cessation as Medication Assisted Treatment

Linda Hurley, LCDCS, CODAC, Inc., Providence, RI

Dana McCants Derisier, MS, Rhode Island Department of Health, Providence, RI

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

Opioid Treatment Programs (OTPs) serve the largest number of individuals disparately impacted by tobacco use. Although well-positioned to deliver evidence-based tobacco treatment to patients as a form of medication assisted treatment—historically, they do not. Yet, current research suggests that patients who are “ready for a significant change,” respond favorably to addressing more than one “problem” behavior. CODAC presenters will discuss becoming the first tobacco free OTP in RI (and among the first nationally). Topics include: creating and enforcing a tobacco free policy; offering cessation services to staff and patients; participating in statewide tobacco initiatives; and creating sustainability.

 

Learning Outcome (s): Describe how to utilize evidence based practices and enhanced protocols to support tobacco cessation programming concurrently with addiction and/or mental health treatment; Identify findings that illustrate how patient outcomes reflect the impact of shifts in agency culture toward comprehensive tobacco treatment within a tobacco free environment; Examine a blueprint for how to develop and integrate tobacco cessation programming and tobacco free policy into systems of care.

 

F3 – Recognizing and Addressing Problem Gambling in Patients Receiving Medication Assisted Treatment

Chris Welsh, MD, University of Maryland School of Medicine, Baltimore, MD

Lori Rugle, PhD, Maryland Center of Excellence on Problem Gambling, Columbia, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop will provide an overview on the topic of problematic/pathological gambling, which may be present in greater than 50% of patients in methadone treatment. It will cover DSM/ICD diagnostic criteria, epidemiology, comorbidities and possible treatments. It will also describe common screening instruments, educational materials, and brief interventions to address gambling problems. It will show how to focus on gambling behaviors in the context of recovery from opioid addiction. The workshop will utilize presentation of factual information as well as interactive case examples and role-play of screening and interventions.

 

Learning Outcome (s): Describe three of the most common risk factors/co-morbidities for problematic gambling in patients with substance use disorders; Identify three commonly used brief screens for problematic gambling; List three useful pieces of information to convey to patients regarding the role of gambling in recovery

 

F4 – The Challenges of Treating Chronic Pain and an Opioid Use Disorder in Medication Assisted Treatment

Mark L. Kraus, MD, Connecticut Counseling Centers, Inc., Danbury, CT

Joseph G. Conrad, PsyD, Connecticut Counseling Centers, Inc., Danbury, CT

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This workshop will provide an in depth look at a patient population that we see in our Medication Assisted Treatment (MAT) Programs and Primary Care Settings, i.e., those patients who struggle with a primary opioid use disorder and are concomitantly being treated for chronic pain. The workshop content will be focusing on issues inclusive of epidemiology, triage, and intervention in regard to the physician’s and clinician’s role in managing these patients to achieve the best possible therapeutic and medical outcomes. Specific focus will also be given to addressing prescription practices and discussing an “Integrative Model of Care.”

 

Learning Outcome (s): Describe the present opiate epidemic and role of the physician and behavioral health clinician; Identify options for pain management for the opioid dependent patient; Explain the epidemiology and disease burden of MH/substance-related disorders and chronic non-malignant pain (CNMP)

 

F5 – Youth Treatment: Current Research and Clinical Approaches

Marc Fishman, MD, Maryland Treatment Centers, Johns Hopkins University, Baltimore, MD

Shannon Mitchell, PhD, Friends Research Institute, Baltimore, MD

Hoa Vo, PhD, Maryland Treatment Centers, Baltimore, MD

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.5

 

This presentation will describe the special developmental vulnerabilities and treatment needs of adolescents and young adults, and review current research findings and innovative clinical approaches on opioid addiction. It will cover an ongoing randomized trial of extended-release naltrexone, and a naturalistic study comparing its effectiveness with buprenorphine. Challenges include the linkages from inpatient to outpatient treatment; use and choice of relapse prevention medications; barriers to retention; the need for developmentally informed approaches to engagement; the encouragement of broader family involvement and support, including the balance of confidentiality vs. family communication; and approaches to ongoing use of non-opioid substances during treatment.

 

Learning Outcome (s): Recall the current literature on youth treatment outcomes; Describe a critical view of current strategies to adapt treatment to the specific developmental needs of youth; Assess the scope and goals and preliminary findings of research currently underway on youth treatment

 

CLOSING PLENARY SESSION – Wednesday, November 2, 2016

11:30 a.m.–12:45 p.m.

 

The Federal Response to the Opioid Epidemic

 

MODERATOR:

Mark W. Parrino, MPA, President, American Association for the Treatment of Opioid Dependence, Inc. (AATOD), New York, NY

 

KEYNOTE ADDRESS:

Michael Botticelli, MEd, Director of Office of National Drug Control Policy (ONDCP), Washington, DC

Loretta Lynch, JD, Attorney General, United States Department of Justice, Washington, DC (Invited)

 

Course Target Audience: Beginning, Intermediate & Advanced

 

Number of CE Hours Available: 1.25

 

The Closing Plenary Session will feature two major keynote addresses that cannot be missed for advocates, stakeholders, providers, and patients. As Director of National Drug Control Policy, Mr. Botticelli leads the Obama Administration’s drug policy efforts, which are based on a balanced public health and public safety approach. In response to the national opioid epidemic,

Mr. Botticelli has coordinated actions across the Federal government to reduce prescription drug abuse, heroin use, and related overdoses. These include supporting community-based prevention efforts; expanding use of the naloxone by law enforcement; and increasing access to medication assisted treatment. Director Botticelli will discuss White House policies on National Drug Control. As US Attorney General, Loretta Lynch has pledged to help fight opioid abuse. During this session, Attorney General Lynch will provide insight on current efforts by the Criminal Justice System to save lives, reduce recidivism, and foster recovery for people with substance use disorder. Make sure that your plans make it possible for you to be at this important event!

 

Learning Outcome (s): Describe the expanding use of the naloxone by law enforcement; Describe the public health and public safety approach to combating the opioid abuse; Explain the efforts by the Criminal Justice System to reduce opioid misuse.

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